Recent Advances in Rotator Cuff Surgery

Shoulder pain is the second most common type of pain reported by patients in the United States. The rotator cuff is a complicated structure consisting of four muscle groups that attach to the long bone that connects the shoulder to the elbow.

The muscles and their functions are as follows:

Supraspinatus – Holds the humerous in place and keeps upper arm stable. Also helps with lifting.

Infraspinatus – Main muscle that controls rotation and extension.

Teres Minor – The slim, narrow muscle in the rotator cuff; it assists with rotating the arm away from the body.

Subscapularis – Holds the upper arm bone to the shoulder blade and helps with rotation, holding the arm straight and out and lowering it

Injuries causing pain are common and these injuries usually fall into the following three categories:

Rotator cuff tear – often the result of the wear and tear of daily use.

Tendinitis – an inflammation or irritation of the tendon that attaches to the bone.

Bursitis – irritation of bursa (a small sac filled with fluid that protects the rotator cuff).

Tendinitis and bursitis can get better with nonsurgical treatment.

However, rotator cuff tears often require surgery if physical therapy and medications do not help.

Unfortunately, traditional rotator cuff repair procedures involve suturing tendon to bone and result in long rehabilitation, significant lifestyle changes, and variable outcomes. Which is why many people choose to forego surgery until pain is severe and mobility is significantly impaired. The catch 22 is that as rotator cuff disease progresses, it becomes increasingly difficult to repair.

However, there is a new approach called The Rotation Medical Rotator Cuff System that includes a collagen based bio-inductive implant about the size of a postage stamp. The implant is placed arthroscopically through a small incision over the location of the rotator cuff tendon that is injured. It is secured with small staples. The bio-inductive implant dissolves slowly during the healing process. As it dissolves, it induces growth of new tendon-like tissue, resulting in thicker tendons and replacement of tissue defects.

This technology can be used in earlier stages of rotator cuff disease to slow progression. It can also be used in conjunction with traditional repair procedures to improve tendon biology and decrease the chances of re-tearing the rotator cuff tendon.

The advantages are shorter rehabilitation, faster recovery, potential to prevent or slow down disease progression, and decreased risk of developing a second degenerative tear.